Wallace Kim

Primary specialty

Prosthetics Case ManagementTaxonomy code 1744P3200X

Practice address

3275 E Platte Ave Ste D2
Colorado Springs, CO 80909-6444

Phone

(719) 694-8855

NPI assigned

Feb 17, 2025

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1739750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1487459079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3275 E PLATTE AVE STE D2",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809096444",
            "telephone_number": "719-694-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3275 E PLATTE AVE STE D2",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809096444",
            "telephone_number": "719-694-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "WALLACE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-17",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Minji Kim
• Simon Kim, MD
• Soojin Kim
• Tiffany Bora Kim
• Tony Sung Soo Kim, MD
• Yong Ji Kim, APRN
• Jewel Kimball
• Mary Camille Kimball, R.N., B.S.N.
• Melissa Dee Kimball, MA, LPC
• Kimberly Inman Pmhnp-BC PLLC

• Prosthetics Case Management in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Prosthetics Case Management in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.